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Introduction: Oculogyric crisis which is a dystonic reaction, is commonly caused by neuroleptics and rarely occurs with atypical antipsychotics specially Clozapine. In this article a case of Clozapine induced oculogyric crisis is reported. Case: The patient was a 25 years old woman with auditory hallucination, loosening of association and persecutory delusion that was admitted and treated. Because of poor response to typical antipsychotics, Clozapine was prescribed. Then she experienced multiple episodes of oculogyric crisis and was treated successfully with anticholinergic medication (Artane). Conclusion: In this special case, Clozapine caused oculogyric crisis. This side effect is rare but should be considered as a possible adverse effect of Clozapine. On the basis of this report, Clozapine induced oculogyric crisis may be treated successfully with Artane

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Background: Diabetes Mellitus is a heterogeneous group of different metabolic disorders that are characterized by chronic increase of blood glucose and proteins, lipids and carbohydrates metabolism disorder. The aim of this study was to investigate the effect of 8 weeks of aerobic exercise on metabolic factors, quality of life and mental health of women with type II diabetes. Materials and Methods: In this semi-experimental investigation, 18 women with type П diabetes referring to Arak Petroleum Company Clinic were selected and divided into two groups: aerobic (10 participants) and control (8 participants). Aerobic group performed selected exercises in 8 weeks (three 30-50 min sessions per week). In this investigation, we used metabolic factors (such as total cholesterol, triglycerides, HDL, VLDL, LDL, FBS, HbA1c and Insulin serum) and SF-36 quality of life (QOL) and GHQ mental health (MH) questionnaires. The level of significance was considered to be 95% (P<0/05). Results: There were significant differences between the means of pre-test and post-test measures of FBS, HbA1C, Insulin serum, QOL and MH in aerobic group. There were no significant differences between the means of pre-test and post-test measures of TC, HDL, LDL, VLDL and triglycerides in aerobic group and all factors in the control group (P<0/05). Conclusion: Aerobic exercise affects metabolic factors, QOL and MH in type П diabetic patients and it results in their improvement.

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Background: The aim of this study is to assess antioxidative and pro-oxidative efficacy of ascorbate on serum albumin during iron-induced oxidative stress. Materials and Methods: In this experimental study, albumin was placed in the oxidative system containing iron ions and different concentrations of ascorbate. To monitor albumin degradation, sodium dodecyl sulfate polyacrylamide gel electrophoresis was performed according to Laemmli procedure. Oxidative modification of albumin was demonstrated using a method for determination of carbonyl groups by 2,4-dinitrophenylhydrazine. Results: By applying the carbonyl assay, ascorbate showed a dual effect: initial pro-oxidative effect on albumin changed to an antioxidant one in a dose-dependent manner. Our findings showed prooxidant effects for ascorbate in low concentrations (0-100 µM) and antioxidant effects in higher concentrations (100-300 µM). Also, electrophoretic pattern of plasma proteins showed significant protein aggregations in the range of 35 to 45 kDa of MW and protein degradations in the range of 115 to 180 kDa. Conclusion: Ascorbate can produce reactive oxygen species and can also inhibit the production of these oxidants in the presence of iron ions as well. These findings may be directly applicable to oxidative states during the administration of ascorbate and may be important in preventing oxidative modifications of proteins in blood circulation and other biological fluids.

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Background: Enterococcus is known as an important pathogen in Iran like all around the world. The increasing use of vancomycin makes vancomycin-resistant enterococci (VRE) an important nosocomial pathogen. Vancomycin in combination with an aminoglycoside can provide effective treatment for severe enterococcus infections, while resistance to vancomycin antibiotic is increasing in enterococci. In this study, the pattern of antibiotic resistance and prevalence of vancomycin resistance enterococci have been explored. Materials and Methods: In this experimental study, after isolating and identifying 150 strains of enterococci from clinical specimens, the antibiotic resistance pattern of these strains to erythromycin, teicoplanin, vancomycin, ciprofloxacin, tetracycline, gentamicin, co-trimoxazole and linezolid was examined. The MIC test by using micro dilution broth method was performed for the vancomycin resistance enterococci specimens with the vancomycin and teicoplanin antibiotics. Results: Antibiotic susceptibility test showed 14% and 5.3% of the samples were resistant to vancomycin and teicoplanin respectively. Resistant to erythromycin, co-trimoxazole, ciprofloxacin, tetracycline, linezolid and gentamicin were 64, 40, 38.6, 6.6, 0, 38.76 percent respectively. Fourteen samples had high resistance to vancomycin which MIC were ≥ 256 µg/ml. Conclusion: Based on the results of present study, there are vancomycin-resistant enterococci in Arak as well as other parts of the world. The percentage of vancomycin resistance enterococci is high in Arak and appropriate treatment of infections caused by enterococcus is essential

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  Background: Due to the lack of efficient anti-HIV vaccine, anti-HIV pharmaceuticals play an important role in controlling HIV infection. Also significant rise in drug resistance and drug toxicity has caused increased interest in finding new anti-HIV agents. In this study, a nano-sized version of lamivudine based on PEGylated chitosan was synthesized.

  Materials and Methods: In this research, nanoparticles of chitosan were efficiently PEGylated for increasing their stability in water and then the anti-HIV drug, lamivudine, was loaded on these PEGylated nanoparticles. After purification and lyophilization of new synthesized nanoparticle, the raw materials and final product were sampled and FTIR, HNMR and CHN analyses were done.

  Results: Results of HNMR spectroscopy showed that chitosan nanoparticle was successfully PEGylated. HNMR data confirmed FTIR results and indicated that lamivudine was conjugated on chitosan nanoparticle. In addition, CHN analysis data also confirmed both HNMR and FTIR data, and demonstrated that a high yield of chitosan nanoparticle PEGylation (approximately 97%) was done and illustrated a high capacity of lamivudine conjugation on nano-sized PEGylated chitosan (30% _W/W chitosan).

  Conclusion: In this study, lamivudine drug was successfully synthesized, based on PEGylated chitosan nanoparticle.

 

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Background: Considering that pre-diabetes is one of disorders that increases developing of diabetes, this study was performed to investigate the effect of L-Arginine supplementation on antioxidant enzyme activity, total antioxidant capacity, and body composition in patients with pre-diabetes.

Materials and Methods: A double-blinded randomized clinical trial was performed on 46 pre-diabetic patients. Patients in intervention (n=23) and  placebo groups received  3g/day L-arginine and placebo (three 1gr L-arginine capsules), respectively for 8 weeks. Anthropometric, body composition, and dietary intake assessments, and also biochemical tests were done at baseline and end of study. Total Antioxidant Capacity (TAC), glutathione peroxidase enzyme and superoxide dismutase activity were measured. Paired t-test, independent t-test and ANOVA were used to analyze quantitative variables.

Results: Thirty eight patients (19 subjects in each group) completed the study. After adjusting confounding factors, no significant difference in body composition, anthropometric indices and dietary intake was observed at the end of study (p<0.05 in all factors), but a significant difference in TAC level was observed in the intervention group at the end of study (p<0.001).

Conclusion: Supplemenation with 3gr/day L-arginine for 8 weeks led to raised serum TAC level without changes in body composition in pre-diabetic patients.

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Background: One of the amendments made in Iran's Health System was family physician program were introduced in 2004 . This study aimed to describe the experiences of physician and other health team members about general interest of this program.

Materiasl and Methods: This study is a qualitative and data collection method was in-depth interviews (semi-structured). Groups participants including 15 physicians, 15 midwives and 25 healthworker declare their experiences about of general advantage in this program. In total, 55 interviews were carried out in population. Purposive sampling fand content analysis with comparative of the methods were used.

Results: In this study, after continuous analysis of data 376 initial codes were obtained. After integration of theses codes 30 the secondary cods come out which consist of public or general interest and economic benefit, respectively. Moreover 4 sub-categories (improve of index of public health and care, health folder, insurance for rural, low referral to expert of physican), were created.

Conclusion: Based on the results the use of electronic folders instead of traditional folder and accelerate to acsess of information patient for promotion of care and finally delivery some facilitate for health team worker recommended.

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Background: Nanomaterials have gained increasing attention because of their novel properties, including a large specific surface area and high reaction activity. This study was designed to investigate the cytotoxic effects of CuO nanopaticles on brain, spleen, and embryo NMRI pregnant mice.

Materials and Methods: In this experimental study, forty two female NMRI mice of (weighting 30±3.0 g) were randomly divided into six groups (four experimental groups, one sham group and one control group).The experimental mice on days 3 and 12 of pregnancy received CuO nanoparticle with concentrations 50, 100, 150, 200 mg/kg intraperitoneal injection. On day 17 pregnancy, brain, spleen and fetus weights were measured.Tissues for histopathological evaluation were stained with hematoxylin and eosin.

Results: Based on the macroscopic observations of embryos weight with increasing concentration of nanoparticle compared to control reduces its toxicity increased (p&le0.05). Spleen only at concentration of 600 mg/kg showed significant changes compared to control (p&le0.05). Histopathologic examination on brain and spleen following IP administration of CuO nanoparticle showed signs of cytotoxicity (congestion, necrosis, inflammatory cell infiltration, vacuolar degeneration) and (congestion, necrosis, increased hemosiderin) compared to control group, respectively.

Conclusion: The present study clearly showed that CuO-NPs can produce the histopathological abnormalities on brain and spleen tissues of NMRI mice in a dose-dependent manner.

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Background: The type of dressing used has great effct on pain relief when dressing patients is changed. So this study is performed to compare the effect of Acticoat dressing and normal dressing on pain of burn patients during dressing change.

Materials and Methods: This clinical trial was done on 64 patients with second and third degrees burn wounds in Vali-asr hospital. The patients were randomly divided in two groups (receiver of the Acticoat) and control (the receiver of silver sulfadiazine cream 1%) for 15 days. Pain was examined during dressing change by using numerical evaluation of the degree of pain on the first, seventh and fifteenth days. Finally, the data was examined by using statistical tests, Chi-square, Mann-Whitney tests, RM ANOVA.

Results: The results showed that there was no significant differences between the groups in baseline pain intensity statistically (p=0.20). Pain intensity had statistically significant difference in the experimental group and control group in the seventh and fifteent days of the study (p>0.001) so that the experimental group experienced less pain.

Conclusion: Acticoat dressing is a simple and practical method in burn patients according to the present results of study which is preferred in terms of reducing pain during dressing change compared to the conventional method.

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Background: Phacoemulsification is a modern cataract surgery that developed surgery from large incisions into smaller incision size and lead to faster wound heal and earlier visual rehabilitation. The purpose of this study was to compare the outcomes and complications of 3.2 and 2.65 mm main Incisions in phacoemulsification .

Materials and Methods: In this clinical study in Amir Kabir Hospital of Arak, 78 patients with senile cataract were divided into two groups. Half of them experienced 3.2 mm main incision (first group) and the others were under main incision with 2.65 mm (group 2). Immediately after operation if patients had a wound leak, the standard stromal hydration was used and a suture was placed. A day after operation, the patients were examined in the light of iris prolapse, if it existed, then a suture would be palced.

Results: The occurrence of anterior chamber wound leak was 7.7% and 2.6% in group 1 and group 2, respectively. Stromal hydration was needed 5.1% and 3.2% in group 1 and group 2 respectively. In fact, suture was needed 2.6% and 0.0% in group 1 and group 2, respectively. There was no iris prolapse in both groups.

Conclusion: There was no statistically significant difference between two groups from the point of view of wound leak and the need for suture and the rate of iris prolapse (p>0.05). Also, in low or intermediate nuclear density grade, the smaller and the more permanent incision with 2.65 mm is preferred.

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  Background: The effect of exercise training on body weight and visceral fat have been examined in several studies, whereas those of aerobic training along with the different dosages of intramuscular vitamin D on body weight, visceral fat and food intake are unknown. The main objective of the study was to assess the effect of aerobic training and different doses of intramuscular vitamin D on body weight, visceral fat and food intake in female Wistar rats.

  Materials and Methods: In this experimental study, seventy-two female Wistar rats were divided into 9 with 8 rats in each group, one group: aerobic training (3 days/week for 8 weeks), three groups: aerobic training and vitamin D supplementation (in high, moderate and low doses ), three groups: vitamin D supplementation ( in high, moderate and low doses ) and two control groups. One-way ANOVA and repeated measures ANOVA test were used to analyze the data.

  Results: Results showed that body weight and visceral fat in aerobic training with high dose vitamin D supplementation group was significantly lower than other groups. Also, the mean food intake in three groups of (aerobic training with low dose vitamin D supplementation , low dose vitamin D supplementation and control) w as significantly higher than other groups.

  Conclusion: It seems that aerobic training with high dose vitamin D compared to using each of the strategies is more effective in decreasing body weight, visceral fat in female Wistar rats .

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Background: Brucellosis is one of the most important diseases among humans and animals. Clinical management of brucellosis due to an increased rate of treatment failure and recurrence is extremely worrying. The aim of this study was to determine the antimicrobial susceptibility pattern of the brucella isolates.

Materials and Methods: From April to September 2014 a total of 30 brucella isolates that were cultured on brucella agar has been studied. The species identification was carried out and to determine the effect of antibiotics on bacteria antibiogram testing was performed by disk diffusion.

Results: In this study, 30 brucella strains were isolated from cultured specimens and antibiogram testing was performed. All microbial positive specimens were sequenced by PCR. All isolates were Brucella melitensis. According to the tests, suceptibility to tetracycline, minocycline, gentamicin, tigecyclin was 100%, to doxycycline 93.3%, co-amoxiclave 66.7%, rifampin 44.7%, streptomycin 86.7%, ciprofloxacin 80%, cotrimoxazole 76.7% and ceftriaxone 73.3%.

Conclusion: This study shows that the predominant strain in our patients was Brucella melitensis. Also, due to high levels of resistance to rifampin to use the other effective drugs like gentamicin, streptomycin, ciprofloxacin or cotrimoxazole in combination with doxycycline or tetracycline.

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Background: chitin and its derivates microparticles (MPs) have immunomodulatory activities. In this study, we examined the effect of size, purity and acetylation degree of chitin MPs on CHID1- encoding SI-CLP, involved in inflammation- gene expression in mixed leukocyte culture.

Materials and Methods: Small (<40m) and medium(40-70m) sized chitin MPs were prepared by sonication, and they were used in treatment of leukocyte mixed culture in comparison with chitosan and also shrimp shell small-sized MPs. Neutral red uptake assay and microscopic examination of apoptosis were used to assess cytotoxicity of MPs. Finally, following cell treatment with MPs (100 μg/mL) for 48h, expression levels of CHID1 gene were determined by Real Time PCR.

Results: Different concentrations of chitinous MPs hadn’t any cytotoxic effects. In gene expression analysis, small-sized chitin MPs (<40 µ) resulted in down regulation of CHID1 gene expression (p=0.004), while other MPs didn’t change it significantly.

Conclusion: Size, purity and acetylation degree of chitin MPs influence their interference in immune cells interactions and it seems small-sized chitin MPs can potentially modulate immune responses through decreasing CHID1 gene expression. Using small-sized chitin MPs may be effective to treat allergies which their treatment strategies rely on modulating the immune responses.

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Background: The speech disorders may produce irreparable damage to childs speech  and language development in the psychosocial view. The voice, speech sound production and fluency disorders are speech disorders, that  may result from delay or impairment in speech  motor control mechanism, central neuron system disorders, improper language stimulation or voice abuse.

Materials and Methods: This study examined the prevalence of speech disorders in 1393 Arakian students at 1 to 6th grades of primary school. After collecting continuous speech samples, picture description, passage reading and phonetic test, we recorded the pathological signs of stuttering, articulation disorder and voice disorders in a special sheet.

Results: The prevalence of articulation, voice and stuttering disorders was 8%, 3.5% and%1 and the prevalence of speech disorders was 11.9%. The prevalence of speech disorders was decreasing with increasing of student’s grade. 12.2% of boy students and 11.7% of girl students of primary school in Arak had speech disorders.

Conclusion: The prevalence of speech disorders of primary school students in Arak is similar to the prevalence of speech disorders in Kermanshah, but the prevalence of speech disorders in this research is smaller than many similar researches in Iran. It seems that racial and cultural diversity has some effect on increasing the prevalence of speech disorders in Arak city.

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Abstract

Background: The aim of this study was to evaluate the effectiveness of of transcranial direct current stimulation (tDCS) on working memory in patients with major depression.

Materials and Methods: The research method was quasi-experimental with pretest and post-test and follow-up with control group. The research population comprised female outpatient referrals to private psychiatric centers and psychological counseling centers in Tehran in the first half of 2016, They had received a diagnosis of depression by a psychiatrist at least once. Of these, 30 females were selected as a sample group with convenience sampling method and based on the criteria of inclusion and exclusion and were divided randomly into two groups , experimental (n = 15) and control (n = 15) group. The experimental group received transcranial direct current stimulation (tDCS) in 10 sessions, While this intervention was not provided to the control group. The data were collected by N-BACK. Analysis of variance with repeated measurments was used to test the research hypothesis.

Results: The results showed that transcranial direct current stimulation (tDCS) had a significant effect on increasing working memory and the impact will continue to follow up.

Conclusion: Therefore, this approach can be used to improve working memory in people with major depression.

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Background and Aim: Fungal infections are among the most critical and common issues for hospitalized patients, especially in intensive care units. This study aimed to determine the fungal contamination of indoor air and surfaces in sensitive wards of the Arak University of Medical Sciences educational hospitals and determine the drug susceptibility pattern of isolated species.
Methods & Materials: In this descriptive cross-sectional study, 63 air samples were taken from sensitive hospital wards using the one-stage Anderson method, and 63 surfaces samples were taken using wet cotton swabs and cultured in saprodextrose agar medium containing chloramphenicol. Identification of the genus and, as far as possible, the species of fungi was performed using the culture method on the slide. Drug susceptibility testing was performed on isolated species by broth microdilution method (CLSI-M38A2 standard). 
Ethical Considerations: This study was approved by the Research Ethics Committee at Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1395.315).
Results: From the total samples, 18 species of fungi were isolated. These included: Aspergillus niger (8), Aspergillus flavus (4), Aspergillus fumigatus (2), Rhizopus spp. (2), Mucor spp. (1) and Fusarium spp. (1). In the drug sensitivity assay, instances of resistance included: Partial sensitivity of Aspergillus fumigatus to Itraconazole (1), Partial sensitivity of Aspergillus niger to Ketoconazole (1), and Resistance of Aspergillus niger to Itraconazole (1).
Conclusion: The pattern of nosocomial fungal infection with pathogenic fungi and the drug susceptibility pattern of these organisms in other regions of Iran and the world is relatively consistent with the present study results. And drugs listed in global guidelines for treating these infections, such as voriconazole and caspofungin in the treatment of invasive aspergillosis and amphotericin B in the treatment of invasive mucormycosis and Fusarium wilt, are now effective drugs.

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Background and Aim: The main objective of the current study was to compare the effectiveness of schema therapy and dialectical behavior therapy (DBT) on health-promoting lifestyle (HPL) and quality of life (QoL) of HIV/AIDS patients. 
Methods & Materials: The current study was an experimental study based on a pre-test-post-test design with a control group, and based on the objectives, it can be considered an applied study. The statistical population of the study included all HIV patients monitored by behavioral disorders clinics of the Healthcare Organization Centers in Hamedan County in Iran in 2019-2020. Using simple random sampling method, 45 patients were randomly selected from Shohada Clinic in Hamedan as the sample of the study, followed by randomly assigning them to three 15-member groups, i.e., two intervention groups and a control group. In order to measure the research variables, the Health-Promoting Lifestyle Profile (HPLP) (1987) and the Short Form (36) Health Survey (SF-36, 2001) were utilized. The obtained data were analyzed using ANCOVA in SPSS v. 12.
Ethical Considerations: The Ethics Committee of Hamedan University of Medical Sciences approved the study (Code: IR.UMSHA.REC.1398.1063). This study has been registered in the Iranian Registry of Clinical Trials (Code: IRCT20120215009014N348).
Results: The results of ANCOVA indicate that schema therapy and DBT affect HPL and quality of life, and there was a significant difference between the two groups (P‌<‌0.001). 
Conclusion: The results show that while both therapy methods affect the selected variables, schema therapy is more effective than DBT on HPL and Quality of Life (QoL). 

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Background and Aim: Among the different periods of human life, adolescence is one of the most important and valuable periods of each personchrs life and anxiety is very common in this period of development and can continue into adulthood. One of the concerns is health concern so it is the best time to target the efforts of preventive behavior during adolescence. Therefore, this study was conducted to investigate the effect of group-based puberty counseling on problem-solving health concerns of adolescent girls.
Methods & Materials: This study is an educational trial with a pre-test and post-test design that is performed on 60 female students aged 15-18 years in Tehran (30 in the experimental group and 30 in the control group) who meet the inclusion criteria and by sampling method. Two-stage cluster random sampling was performed. Data were collected using a questionnaire containing demographic information and a standard health concern questionnaire. The intervention was designed by group discussion during 6 sessions for the experimental group and after 2 months, information was collected from both groups and analyzed by chi-square, independent t-test and paired t-test.
Ethical Considerations: This study was approved by the Research Ethics Committee of Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1397.262), and all participants have read and signed the informed consent.
Results: According to the results of the study, before the educational intervention in the experimental group, the mean scores of anxiety in: personal health were 3.90, sexual health was 3.77, communication was 3.83, emotional health was 5.43 and the total score of anxiety was 16.10. The intervention had changed to 2.53, 2.03, 2.97, 3.30 and 10.90, respectively. This change was significant in the areas of sexual health, emotional health and total anxiety score (P<0.005). Also, the experimental and control groups, after the educational intervention, had significant differences in the areas of personal health, emotional health and total anxiety score (P<0.005).
Conclusion The results of the intervention showed that group discussion can reduce the health concerns of adolescent girls.

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